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Complex case management

Kannan Govindan, P C Jha, Vernika Agarwal, Jyoti Dhingra Darbari
The Indian electronics industry is facing immense pressure to include sustainability practices in order to meet customer expectations, comply with legislation and create an edge over competitors. This growing need for inclusion of sustainability is driving original equipment manufacturers (OEMs) to collaborate with third-party reverse logistics providers (3PRLPs) to sustainably manage returns. Collaboration with 3PRLP will put OEMs in a stronger position regarding compliance with government legislation, improving upon their corporate image and customer satisfaction...
February 15, 2019: Journal of Environmental Management
Michał Słowiński, Mariusz Lamentowicz, Dominika Łuców, Jan Barabach, Dariusz Brykała, Sebastian Tyszkowski, Anna Pieńczewska, Zbigniew Śnieszko, Elisabeth Dietze, Krzysztof Jażdżewski, Milena Obremska, Florian Ott, Achim Brauer, Katarzyna Marcisz
In recent decades, it has been observed that most forest fires in Europe were caused by people. Extreme droughts, which are more often prolonged, can increase the risk of forest fires, not only in southern Europe but also, in Central Europe. Nonetheless, catastrophic fire events are not well recognized in the Central European Lowlands (CEL), where large forest complexes are located. Knowledge of past fire activity in this part of Europe is scarce, although several fires have occurred in this area during the previous millennia...
February 15, 2019: Journal of Environmental Management
Ana López-López, María Luisa Poch-Olivé, Javier López-Pisón, Esther Cardo-Jalón
Attention deficit hyperactivity disorder (ADHD) is a complex and heterogeneous neurodevelopmental disorder, of a chronic nature, of multifactorial etiology, mainly due to genetic and environmental factors. We conducted a retrospective analytical study of the t herapeutic management of children diagnosed with ADHD. A sample of 82 children diagnosed with ADHD (74.4% children and 25.6% girls) was studied. 96.3% of the cases presented some associated disorder. Pharmacological treatment was the treatment of choice (90...
2019: Medicina
Badar Ul Islam, Nasimudeen R Jabir, Shams Tabrez
Alzheimer's disease (AD) is a complex, progressive, irreversible neurodegenerative disorder. Recent reports suggest that it affects more than 36 million people worldwide and accounts 60-80% of all cases of dementia. It is characterized by aberrations of multiple interactive systems and pathways, which ultimately lead to memory loss and cognitive dysfunction. The exact mechanisms and initial trigging factors that underpin the known pathological defects in AD remain to be fully elucidated. In addition, an effective treatment strategy to reduce the progression of AD is yet to be achieved...
February 18, 2019: Journal of Drug Targeting
Natsumi Fujii, Makoto Ideguchi, Takafumi Nishizaki, Norio Ikeda, Taichi Shimabukuro, Tomomi Okamura, Machiko Oono
Background: We present a case of tentorial dural arteriovenous fistula (TDAVF) causing subarachnoid hemorrhage with mass effect of large venous pouches, which was struggling to diagnosis and management due to complex vasculature and severe general condition. Case Description: A 43-year-old man was transferred to our hospital due to sudden consciousness disturbance. A neurological examination revealed tetraparesis and pupil dilatation with no light reflex. Imaging findings showed a large lesion in the brainstem with subarachnoid and intraventricular hemorrhage...
2019: Surgical Neurology International
Wendy Jo Svetanoff, Benjamin Zendejas, Farokh R Demehri, Alex Cuenca, Bharath Nath, C Jason Smithers
Introduction: There are no reported survivors of gastroschisis with complete liver herniation. We describe a case report of two patients, one of whom survived. Case #1: The patient was born with gastroschisis and herniation of the entire liver. Along with silo placement, the abdominal fascia was attached to an external traction system for growth. Complete closure was achieved at 5 months. Due to pulmonary hypoplasia, high-frequency ventilation was required. The patient is doing well, on a home ventilator wean, at 20 months...
2019: Case Reports in Surgery
Syeda Beenish Bareeqa, Fazeela Bibi, Syed Ijlal Ahmed, Syeda Sana Samar
Background: Cardiac muscle possesses a limited capacity to regenerate its tissue on its own. It is less likely to reverse the altered cardiac functioning to its normal physiological state after a major myocardial infarction. Stem cell transplantation provided a unique therapeutic approach in managing such injuries. There has been a substantial debate about the complexity, scope and medical application of stem cell transplantation in past few years. Materials and Methods: An extensive review of medical literature was conducted to establish the consensus about the possible mechanism of cell renewal, associated complications and risks of failure of this technique...
October 1, 2018: International Journal of Hematology-oncology and Stem Cell Research
Tom H E Mason, Chris R J Pollard, Deepthi Chimalakonda, Angela M Guerrero, Catherine Kerr-Smith, Sergio A G Milheiras, Michaela Roberts, Paul R Ngafack, Nils Bunnefeld
Conservation conflict is widespread, damaging, and has proved difficult to manage using conventional conservation approaches. Conflicts are often "wicked problems," lacking clear solutions due to divergent values of stakeholders, and being embedded within wickedly complex environments. Drawing on the concept of wicked environmental problems could lead to management strategies better suited to tackling conflict. However, it is unclear whether managers are embracing ideas from the wicked problems concept...
November 2018: Conservation Letters
Davide Martino, Tammy Hedderly
Tics and stereotypies are the most common pathological repetitive complex motor behaviors occurring during the neurodevelopmental period. Although they may appear transiently during development without acquiring a pathological status, when they become chronic they may be distressing, socially impairing, or even, in the case of malignant tics, potentially physically harmful. Despite a certain similarity in their phenomenology, physicians should be able to distinguish them for their different variability over time, topographical distribution, association with sensory manifestations, and relationship with environmental triggers...
February 4, 2019: Parkinsonism & related Disorders
Yair M Gozal, Gmaan Alzhrani, Hussam Abou-Al-Shaar, Mohammed A Azab, Michael T Walsh, William T Couldwell
OBJECTIVECavernous sinus meningiomas are complex tumors that offer a perpetual challenge to skull base surgeons. The senior author has employed a management strategy for these lesions aimed at maximizing tumor control while minimizing neurological morbidity. This approach emphasizes combining "safe" tumor resection and direct decompression of the roof and lateral wall of the cavernous sinus as well as the optic nerve. Here, the authors review their experience with the application of this technique for the management of cavernous sinus meningiomas over the past 15 years...
February 15, 2019: Journal of Neurosurgery
David Pilecky, Mate Vamos, Peter Bogyi, Balazs Muk, Dora Stauder, Hajnalka Racz, Noemi Nyolczas, Gabor Z Duray, Gabor Zacher, Endre Zima
OBJECTIVE: Patients with electrical injury are considered to be at high risk of cardiac arrhythmias. Due to the small number of studies, there is no widely accepted guideline regarding the risk assessment and management of arrhythmic complications after electrical accident (EA). Our retrospective observational study was designed to determine the prevalence of ECG abnormalities and cardiac arrhythmias after EA, to evaluate the predictive value of cardiac biomarkers for this condition and to assess in-hospital and 30-day mortality...
February 15, 2019: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Carsten Nieder, Matthias Guckenberger, Laurie E Gaspar, Chad G Rusthoven, Dirk De Ruysscher, Arjun Sahgal, Timothy Nguyen, Anca L Grosu, Minesh P Mehta
BACKGROUND: Different management options exist for patients with brain metastases from non-small cell lung cancer (NSCLC), patients whose treatment with whole brain radiotherapy (WBRT) has become more controversial over the last decade. It is not trivial to find the optimal balance of over- versus undertreatment in these patients. Several recent trials, including the randomized QUARTZ trial now influence the decision to recommend or withhold WBRT for patients with unfavorable prognosis, and similarly, for favorable prognosis patients, the balance between radiosurgery alone or WBRT has become a nuanced decision...
February 15, 2019: Radiation Oncology
Ji Wook Jeong, Zegar Zegar, Richard Y Liu, Scott R Makins
Knowledge of the prevalent root canal anatomy and potential variations is necessary before the initiation of endodontic treatment. The purpose of this study was to aid in the detection and treatment of the Vertucci type V canal configuration when present in the distal root of the mandibular molars. This case series presents 3 radiographic indications of a type V configuration in the distal roots of the mandibular molars as revealed on conventional periapical radiographs: a "ghost" apex, a fast break canal, and eccentric canal tracing...
February 12, 2019: Journal of Endodontics
Giacomo Colletti, Federico Biglioli, Tito Poli, Margherita Dessy, Marco Cucurullo, Mario Petrillo, Stavros Tombris, Milton Waner, Enrico Sesenna
Vascular malformations are often found inside the orbit. Isolated venous malformations (frequently misnamed as cavernous hemangiomas) are the most frequent among these. However, also lymphatic and arteriovenous malformations can affect the orbit. The complex anatomy of the orbit and the fact that its content easily suffers from compartmental syndrome explain why treating orbital vascular malformations can be challenging and technically demanding. In this study, two institutions have retrospectively collected their cases, consisting in a total of 69 vascular malformations of the orbit...
September 20, 2018: Journal of Cranio-maxillo-facial Surgery
Esaú Fernández-Pascual, Francisco Javier Gonzalez-García, María Rodríguez-Monsalve, Jorge Turo, Claudio Martínez-Ballesteros, Joaquín Carballido, Juan Ignacio Martínez-Salamanca
INTRODUCTION: Patients with Peyronie's disease (PD) and erectile dysfunction (ED) concomitant with shortening or other malformations benefit from prosthesis implantation and penile lengthening procedures. AIM: To evaluate the safety and efficacy of a multi-incisional technique with penile prosthesis implantation with multiple corporeal incisions and collagen grafting for the surgical management of complex cases of PD with ED and severe penile shortening. METHODS: From February 2015-May 2018, 43 consecutive patients with complex PD were treated using this technique...
February 2019: Journal of Sexual Medicine
Fouad Chouairi, Michael R Mercier, J Scott Persing, Kyle S Gabrick, James Clune, Michael Alperovich
PURPOSE: Being one of the most common congenital hand malformations, syndactyly is repaired by orthopedic, plastic, and fellowship-trained general surgeons. Limited multi-institutional outcomes analyses regarding incidence, timing, and type of repair exist. METHODS: All syndactyly cases performed over a 5-year period from 2012-2016 were isolated from the National Surgical Quality Improvement Program Pediatric database. Patient demographics, surgical factors, perioperative outcomes, and risk factors were analyzed using χ2 , Fisher exact, and t-test analysis...
February 15, 2019: Hand: Official Journal of the American Association for Hand Surgery
David Benjamin Lumenta, Gerald Sendlhofer, Gudrun Pregartner, Marlies Hart, Peter Tiefenbacher, Lars Peter Kamolz, Gernot Brunner
BACKGROUND: Tumor boards (TB) play an important role to formulate a management plan for the treatment of patients with a malignancy. Recent evidence suggests that optimally functioning teams (teamwork, communication and decision making) are major prerequisites to conduct efficient TB meetings. The aims of this study were i) to use a readily published tool as a template for the development of a teamwork perspective extended assessment tool and ii) to evaluate the tool in a feasibility study by clinical and non-clinical observers...
2019: PloS One
Rikke Aarhus, Tine Tjørnhøj-Thomsen, Britta Tarp, Peter Vedsted, Rikke S Andersen
OBJECTIVE: Healthcare systems increasingly make use of case managers to handle organisational complexity. In Danish cancer patient pathways, case managers handle the complexities of cancer diagnostics and treatment while adhering to pathway guidelines. This article explores how case managers handle their various responsibilities and focuses on the micro-politics of case management. METHODS: An ethnographic study was carried out in three Danish cancer patient pathways...
February 14, 2019: European Journal of Cancer Care
Zhen-Yu Liao, Shen-Chang Lin
BACKGROUND Despite improvements in percutaneous coronary intervention (PCI) devices and operator expertise, coronary chronic total occlusion (CTO) poses a management dilemma for interventional cardiologists. Occasionally, in CTO lesions and in bifurcation lesions with severe curvature and stenosis, wires cannot be introduced into the main artery, although wiring into the side branch is possible. We herein report a case of stumpless ostial left anterior descending artery (LAD) CTO that was successfully treated with a novel strategy...
February 15, 2019: American Journal of Case Reports
Matteo Brucoli, Paolo Boffano, Emanuele Broccardo, Arnaldo Benech, Pierre Corre, Helios Bertin, Petia Pechalova, Nikolai Pavlov, Petko Petrov, Tiia Tamme, Andrey Kopchak, Andrii Hresko, Eugen Shuminsky, Emil Dediol, Marko Tarle, Vitomir S Konstantinovic, Milan Petrovic, Simon Holmes, K Hakki Karagozoglu, Tymour Forouzanfar
PURPOSE: Fractures of the zygomaticomaxillary complex (ZMC) are common injuries that may lead to loss of an aesthetically pleasing appearance and functional impairment. The aim of this study was to analyze the demographics, causes, characteristics, and outcomes of zygomatic fractures managed at several European departments of oral and maxillofacial surgery. MATERIALS AND METHODS: This study is based on a multicenter systematic database that allowed the recording of all patients with ZMC fractures between 1 January 2013 and 31 December 2017...
January 30, 2019: Journal of Cranio-maxillo-facial Surgery
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